Organization
TRUE CHANGE YOUTH HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY CORPENING (MEMBER)
(828) 320-1710
Entity
Organization
Contact information
Practice address
1724 10TH STREET PL NW, HICKORY, NC 28601-1740
(828) 320-1710
Mailing address
47 18TH AVE NW, HICKORY, NC 28601-1822
(828) 320-1710
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/24/2009
Last updated
01/24/2009
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